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A "real-life" study on height in prepubertal asthmatic children receiving inhaled steroids
Elpis Hatziagorou1, Eleana Kouroukli1, Vasiliki Avramidou1
1a Paediatric Endocrinology Unit, 3rd Paediatric Dept, Hippokration Hospital , Aristotle University of Thessaloniki , Greece, Thessaloniki , Greece.
Insights
Inhaled corticosteroids (ICS) are a common asthma treatment for children. This study found that low to medium doses of ICS do not significantly impact height in prepubertal children, easing concerns about growth inhibition.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Growth and Development
Background:
- Asthma is a prevalent chronic respiratory condition in children.
- Inhaled corticosteroids (ICS) are the primary treatment for pediatric asthma.
- Concerns exist regarding the potential growth-inhibiting effects of ICS in children.
Purpose of the Study:
- To determine if low or medium doses of ICS are associated with reduced height in prepubertal children.
- To investigate the safety profile of ICS concerning linear growth in pediatric asthma patients.
Main Methods:
- Retrospective study analyzing height measurements every six months.
- Comparison of growth trajectories in three groups: no ICS, low-dose ICS, and medium-dose ICS.
- Inclusion of 284 children aged 3-8 years with mild persistent asthma.
Main Results:
- No significant difference in height measurements was observed among the three treatment groups.
- Height differences remained stable over time across all groups (p > 0.05).
- Analysis showed no significant impact on height, even when stratified by sex.
Conclusions:
- Long-term treatment with low to medium doses of ICS is not linked to height reduction in prepubertal children with asthma.
- Findings suggest ICS are safe for growth in this pediatric population.
- This real-world evidence addresses caregiver and physician concerns about ICS and child growth.
Introduction:
Asthma is the most common chronic respiratory disease in children and inhaled corticosteroids (ICS) constitute the first line of treatment for these patients. However, the potential growth-inhibiting effect of ICS has often been a cause of concern for both caregivers as well as physicians, and there still remains conflict regarding their safety profile.
Objective:
To assess whether the administration of ICS in low or medium doses is associated with height reduction in prepubertal children.
Methods:
We performed a retrospective study to examine the association between ICS treatment and growth deceleration in children with mild persistent asthma. The comparison of height measurements every 6 months from 3 to 8 years of age was conducted among three groups of patients: patients not receiving ICS, patients being treated with low dose of ICS and patients being treated with medium dose of ICS (GINA Guidelines 2015).
Results:
This study included 284 patients (198 male, 86 female) aged 3-8 years; 75 patients were not receiving ICS, 63 patients were on low-dose ICS and 146 patients were on medium-dose ICS. The measured height every 6 months did not differ significantly (p > 0.05) among the three groups while the difference remained stable (p > 0.05), even when we evaluated males and females separately.
Conclusions:
In this "real-life" study we found that long-term treatment with ICS in low or medium doses is not associated with height reduction in prepubertal children with asthma.
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